I'm in the third week with a client whose newborn - who had never latched
on until I saw her at nearly 2 weeks - not only has a tight mouth but
bites.  She mostly pumps for him, because nursing generally results in a
bite at some point that sends her back to the pump until the hurting stops.
Baby is now just over a month old and she can manage to nurse him twice on
a good day.  Many days she's been afraid to nurse him at all. They nurse
best in the morning, but even then he can deliver a "chomp" when she least
expects it.  They had been finger-feeding, but now bottle-feed.  She's
been reluctant to try an SNS, and they were finger-feeding with the
syringe they got at the hospital, which has become too slow for the
quantity he takes.

My best current ideas - not yet implemented by them - are:

* Go back to finger-feeding but use an SNS so he can have a whole feeding
without interruption for refilling.  Every time he bites the finger, exclaim
and pull the finger out, not returning it for, say, 30 sec or a minute.
That way, no matter how he is fed, biting means food is abruptly withdrawn.

*Use an SNS at breast with large tubing, so the flow is fast enough to
keep him busy swallowing.  They had tried their syringe at breast, and
didn't find it made any difference with comfort.

We've tried other things, including nipple shield, stroking his face and
lips before feeds, nursing when he's sleepy, but nothing has seemed to
make nursing consistently tolerable.  He's supplemented with some cow-based
ABM, so there could be an allergic component.  Don't know what to do about
that possibility.

All suggestions gratefully accepted!

Diane Wiessinger, MS, IBCLC, LLLL  Ithaca, NY  [log in to unmask]